Glucocorticoids are adrenocortical steroids, both naturally occurring and synthetic, which are readily absorb from the gastrointestinal tract. Prednisolone (prednisolone (prednisolone (prednisolone tablets) tablets) tablets) is a white crystalline powder, very slightly soluble in water. It is designate chemically as pregna-1,4-diene-3,20-dione,11,17,21-trihydroxy-,(11β)-.
Persons who are on drugs which suppress the immune system are more susceptible to infections than healthy individuals. Chickenpox and measles, for example. Therefore can have a more serious or even fatal course in non-immune children or adults on corticosteroids. In such children or adults who have not undergo these diseases, particular care should be take to avoid exposure. How the dose, route and duration of corticosteroid administration affects the risk of developing a disseminate infection is not familiar. The contribution of the underlying disease and/or prior corticosteroid treatment to the risk is also not familiar. If exposed to chickenpox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicate. If expose to measles, prophylaxis with pool intramuscular immunoglobulin (IG) may be indicate. (See the respective package inserts for complete VZIG and IG prescribing information.) If chickenpox develops, treatment with antiviral agents may be consider.
In patients on corticosteroid therapy subjected to unusual stress increased dosage of rapidly acting corticosteroids before, during, and after the stressful situation is indicate.
Corticosteroids may mask some signs of infection, and new infections may appear during their use. There may be reduce resistance and inability to localize infection when corticosteroids are consume.
Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses.
Usage in Pregnancy
Since adequate human reproduction studies have not been run with corticosteroids. Hence the use of these drugs in pregnancy, nursing mothers or women of childbearing potential requires that the possible benefits of the drug be weigh against the potential hazards to the mother and embryo or fetus. Infants born of mothers who have receive substantial doses of corticosteroids during pregnancy, should be carefully observe for signs of hypoadrenalism.
Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium. These effects are less likely to occur with synthetic derivatives except when used in large doses. Dietary salt restriction and potassium supplementation may be necessary. All corticosteroids increase calcium excretion.
While on corticosteroid therapy patients should not be vaccinate against smallpox.
The use of prednisolone (prednisolone (prednisolone (prednisolone tablets) tablets) tablets) in active tuberculosis should be restricted to those cases of fulminating or disseminated tuberculosis in which the corticosteroid is used for the management of the disease in conjunction with an appropriate antituberculous regimen.
If corticosteroids are indicated in patients with latent tuberculosis or tuberculin reactivity, close observation is necessary as reactivation of the disease may occur. During prolonged corticosteroid therapy, these patients should receive chemoprophylaxis.